Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $3,981.07	Professional		$1,621.81	$1,621.81	$3,981.07
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,454.71	Facility		$1,621.81	$1,621.81	$2,454.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,454.71	Facility		$1,621.81	$1,621.81	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $70.79	Professional		$54.95	$60.26	$70.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $100.00	Facility		$64.57	$64.57	$100.00